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Relations between blood pressure and urinary sodium excretion in a longitudinal population study of 1499 White Europeans never treated for hypertension. K. Stolarz -Skrzypek on behalf of European Project on Genes in Hypertension (EPOGH) Investigators. EPOGH. Introduction.
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Relationsbetweenbloodpressure and urinarysodiumexcretionin a longitudinalpopulationstudy of 1499 White Europeansnevertreated for hypertension K. Stolarz-Skrzypek on behalf of European Project on Genes in Hypertension (EPOGH) Investigators
EPOGH Introduction Excessive sodium intake promotes the pathogenesis of hypertension. Few population studies investigated the association between BP and 24-h urinary sodium excretion (24-h UVNa) as index of salt intake in a prospective way.
EPOGH EPOGH Objectives The assumption that subjects who reduce their salt intake will in the long run have lower blood pressure, has not yet been confirmed in longitudinal population studies. We addressed this issue in 1499 White Europeans recruited in 5 countries, who during their lifetime were never treated for hypertension.
EPOGH Methods EPOGH At baseline and at follow-up the same standardized questionnaire was administered 5 x BP readings at one occasion, mercury sphygmomanometer Height and weight were measured 24hour urine collection, wide-neck containers
FLEMENGHO EPOGH EPOGH EPOGH Recruitment of subjects Recruitment of subjects Baseline 3836 • Unavailable • 222 died • 20 severely ill • 269 moved out • 386 refused • 590 24h urine missing • Excluded • 346 24h urine • undercollected • 504 AHT drugs Follow-up 6.1 yrs (4.3 – 15.9 ) Currentanalysis 1499
EPOGH Population Characteristicsby Country EPOGH B I CZRUPL N 1109 147 69 66 107 Age (yrs)47.344.338.4 42.2 38.6Median follow-up (yrs) 5.67.0 5.7 7.76.6 Gender (% female)51.2 53.4 60.9 63.6 51.4 BMI (kg/m2) BL24.7 24.324.6 23.7 24.3 FU 25.6 25.2 25.4 25.4 25.2 Blood pressure (mmHg) BL121.6/74.3 119.9/77.2 116.7/74.3 115.8/73.4 120.2/75.2 FU124.4/77.7 126.0/83.5 116.7/77.7 119.3/77.1 130.0/90.0 Sodium excretion (mmol/d)BL165173181 198 230 FU 166 169 188 187 189 Between-countries differences were significant, except for BMI
Cross-sectionalanalyses EPOGH EPOGH Adjusted for centre, sex, age, BMI, alcohol intake, 24UVK, use of female sex hormones and NSAIDs
Longitudinalanalyses EPOGH EPOGH Adjusted for centre, sex, baseline and change in: age, BMI, alcohol intake, 24UVK, use of female sex hormones and NSAIDs
Systolic BP by deciles of 24hUVNa EPOGH EPOGH
Conclusions EPOGH EPOGH Salt intake, as exemplified by 24-h UVNa, was consistently and positively associated with SBP in cross-sectional analyses both at baseline and follow-up. Changes in SBP over time follow changes in 24-h UVNa.